Lots of Brooklyn Dr. to stop accepting United Healthcare

[whYME]

I hear that's canceled?

That's what they said about a week ago.

[Moe Ginsburg]

UHC Community Plan is the Medicaid plan. Perhaps parents should switch from United Healthcare to Fidelis, HealthFirst or Empire Blue Cross.

[Shauly101]

I hear that's canceled?

in BP Dr Diamonds Group sent a letter apologizing the any inconveniences but they will continue to accept UHC

[Shauly101]

2 theories as to why the frum community has mainly UHC: First the cynical reason
1. The majority of the frum community unlikely choose anything they are chosen by the whichever  organization the individual uses to "make" his medicaid which usually receives a commission for signing up the patient and I'm assuming United health care pays the highest commission and that is why they are chosen by the organization.
More practical reasoning:
2. It could be back in the day when medicaid was farmed out to the various mentioned companies and you had to sign up with an HMO, probably UHC had a strong drive to sign up the community and their reps went to the heimishe doctors to try to get the patients to sign up with them and with minhag avosaynu biyadainu they continued to sign up with UHC. In Rockland county for example the majority of the frum community is signed up with fidelis even though there are many other free plans including UHC, because of similar reasons that fidelis had a strong signing up drive with the heimishe community.
Other examples include in the north brooklyn (williamsburg) health first and metroplus is very strong in the latin american and africam american community and a good number of heimishe have healthfirst as well, but UHC is probably the lowest represented in that section of brooklyn. Its all dependent on their member sign up drives and maybe commissions.

And why would you rate Fidelis as better than Empire and Healthfirst?
Ans:  I find fidelis's attitude more generous with their medications and not needing prior auths for everything. The reality is all 3  Fidelis, Empire and Healthfirst are generally equally good some heimishe boro park providers never signed up with healthfirst as they dont have too many members in the boro park community but a much stronger presence in williamsburg.
Example for epipen, with fidelis, patients are given the real epipen or the generic made by MYlan which is practically the same company that makes epipen, with healthfirst you need a PA even with the generic and with empire you only get adrenaclick which is a sorry tuches copy of epipen and confusing to use.

Another example for asthma sufferers there are a variety of inhalers  that are allowed to be prescribed. As soon as FDA approved the genereic airduo, UHC dropped all their inhalers in that class and only allows airduo. I have no problems with generics (beggars cant be choosers) but when the company has real shortages of airduo which is a reality now in brooklyn the patients need choices. BTW did I mention doctors hate prior auths.

BTW I dont know if you remember every pharmacy in boro park had a sign "WE STILL ACCEPT UNITED HEALTH CARE" that's because UHC has a knack to randomly throw providers off their network and they threw some local places off. That's usually not issue with the other insurance companies as much as it is with UHC.

Take it from someone in the business You wont go wrong with Fidelis, empire or health first but stay away from UHC.

a lot of Specialty doctors who to not accept Fidelis accept UHC (Dr Tepler as an example) thats the reason i klnow a lot of famalies choose UHC

[TimT]

in BP Dr Diamonds Group sent a letter apologizing the any inconveniences but they will continue to accept UHC

Drs. Diamond, Roth, & Bulmash will continue to accept

[zale]

To give a practical understanding of medicaid HMO
Fidelis = verizon
Empire/healthfirst = ATT
Metroplus & affinity = t mobile
UHC  = sprint

You are comparing apples and oranges. Cellular networks all provide the same thing: phone and internet service. Some have better/faster service, others have poor/slower service.

Healthcare does not work this way. There are thousands of different medical needs and prescriptions. UHC might still outrank all the others in terms of prescriptions, but falls short on doctor compensation for certain visits. Fidelis might be great at doctor compensation, but terrible when it comes to specialized procedures or prescriptions.

UHC is a monster and has a monopoly on certain medical devices and prescriptions. They have exclusive deals with various pharma companies. You might be able to get those medical devices with Fidelis, but not without a long drawn out battle of at least six months to a year. 

[ExGingi]

https://www.crainsnewyork.com/health-pulse/unitedhealthcare-community-plan-drop-nyu-langone-its-network

[Ekay]

I got a letter from NYU that they will no longer accept UCH except for emergencies. This is a very big problem for me as they have a lot of good doctors which were accepting UCH till now.

Can I switch to fidelis before the year is up?

[ExGingi]

I got a letter from NYU that they will no longer accept UCH except for emergencies. This is a very big problem for me as they have a lot of good doctors which were accepting UCH till now.

Can I switch to fidelis before the year is up?

NYC and UHC have been sending out these letters.

I think if you're on Medicaid you are allowed to switch if your Dr. no longer accepts your plan. I don't think that might be the case for other plans.

The mergers and acquisitions in the industry, on the insurers side as well as the hospitals side have led to this major arm twisting fight. My guess is that NYU wins (they might come to an agreement, but UHC will have to compromise on their position).

[Joel]

I got a letter from NYU that they will no longer accept UCH except for emergencies. This is a very big problem for me as they have a lot of good doctors which were accepting UCH till now.

Can I switch to fidelis before the year is up?

Yes I just switched a family member.

[sillypainter]

I have Fidelis child Health plus for my children, am very happy, but they don't cover orthodontics. I read a few days ago in some Jewish paper that UHC covers orthodontics. Can anybody confirm this?

[ExGingi]

I have Fidelis child Health plus for my children, am very happy, but they don't cover orthodontics. I read a few days ago in some Jewish paper that UHC covers orthodontics. Can anybody confirm this?

I know a few kids that got orthodontics on UHC. Not easy to qualify for approval.

[mgarfin]

One of my children was approved the otherr wasn't

[ExGingi]

One of my children was approved the otherr wasn't

Did you try the place in Williamsburg? They manage to get more approvals than most other orthodontists.

[yelped]

Did you try the place in Williamsburg? They manage to get more approvals than most other orthodontists.

ODA?

[ExGingi]

ODA?

No.

IINM Eisenberger on Wallabout.